Cheap approach to prevent diabetes promising

Calling people, educating them on lifestyle changes they could make to avoid developing the disease has proven effective.

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(photo credit:Stockbyte)

A simple, inexpensive method for preventing type 2 diabetes that relies
on calling people and educating them on the sort of lifestyle changes
they could make to avoid developing the disease has proven effective in a
study conducted by researchers at the University of California, San
Francisco (UCSF) and the City of Berkeley Department of Public Health.

The
study involved 230 people in poor, urban neighborhoods in the San
Francisco Bay Area cities of Richmond, Oakland and Berkeley. Contacted
by phone about once a month, half of them received specific dietary
guidance and other lifestyle counseling. After six months, those who had
received the counseling had on average lost more weight, were consuming
less fat, were eating more fruits and vegetables and showed more
improvements in lowering in their blood triglycerides, a key risk
measure for type 2 diabetes.

Described this week in the American Journal of Public Health,
the new intervention is specifically designed for urban, poor, and
predominantly minority communities. It addresses the need for diabetes
prevention interventions in these communities and highlights a simple
fact that doctors at UCSF and elsewhere have been repeating for
years—that type 2 diabetes is preventable in the first place.

“Diabetes
is not something you are necessarily going to get just because it runs
in your family,” said Alka Kanaya, MD, an associate professor of
medicine at UCSF and one of two senior authors on the study. “It is very
preventable, and lifestyle changes can really impact the onset of
diabetes.”

“You can do something about it,” said Anita Stewart,
PhD, a professor at the UCSF Institute for Health & Aging and the
Center for Aging in Diverse Communities who is the other senior author
on the paper.

How lifestyle changes can prevent diabetes

Diabetes
is a chronic and complex disease marked by high levels of sugar in the
blood that arise due to problems with the hormone insulin, which
regulates blood sugar levels. It is usually caused by an inability to
produce insulin (type 1) or an inability to respond correctly to insulin
(type 2).

A major health concern in the United States, diabetes
of all types affect an estimated 8.3 percent of the US population – some
25.8 million Americans – and cost US taxpayers more than $200 billion
annually.

In California alone, an estimated 4 million people (one
out of every seven adults) have type 2 diabetes and millions more are
at risk of developing it. These numbers are poised to explode in the
next half century if more is not done to prevent diabetes.

Previous
studies have shown that counseling and other lifestyle interventions
are effective at preventing type 2 diabetes, but those interventions
have generally been designed for clinical settings and include separate
sessions with numerous health professionals. This makes them expensive
and difficult to scale to large urban populations where diabetes
interventions are needed the most.

Many of this country’s urban
poor face thin health insurance coverage, low literacy, and low income,
and a higher risk of developing type 2 diabetes. These disparities were
apparent in the UCSF study. About half of the study population was
composed of immigrants, and nearly a quarter had no health insurance.
Almost a third said they faced financial hardship, and 22 percent had
less than a high-school education.

By focusing on a phone-based
solution delivered by the Public Health department staff, the UCSF
researchers designed their new intervention specifically as a low-cost
community-based approach that would be relevant to poor, minority and
low-literacy populations. Similar telephone interventions have been used
to reach out broadly to populations in San Francisco and in other
cities to spread lifestyle messages related to hypertension, smoking,
high cholesterol and other issues.

“This adds to our public health toolkit of ways to do outreach and prevent diabetes,” said Kanaya.